title: [Lumbar disc herniation treated with qi pathway intervention and spinal adjustment: a randomized controlled trial].
abstract: OBJECTIVE
  To compare the efficacy difference in the treatment of lumbar disc herniation (LDH) between the comprehensive therapy of qi pathway intervention and the spinal adjustment and the conventional therapy of acupuncture and Tuina and explore the analgesic mechanism.
  
  
  METHODS
  Seventy-one cases were randomized into a comprehensive therapy group (36 cases) and a conventional therapy group (35 cases). In the comprehensive therapy group, the acupoints in the region of abdominal qi pathway were selected and stimulated manually with both hands. In combination, the spinal adjustment therapy was applied. In the conventional therapy group, Shenshu (BL 23), Dachangshu (BL 25), Huantiao (GB 30) and Chengfu (BL 36) on the affected side were selected and stimulated with the conventional needling technique. Additionally, the routine Tuina therapy was applied. Before and after treatment, the visual analogue scale (VAS), Oswestry disability index (ODI) questionnaire, the health related quality of life (SF-36) questionnaire and the level of serum tumor necrosis factor (TNF-alpha) were adopted to determine analgesic effect and clinical efficacy.
  
  
  RESULTS
  In the comprehensive therapy group, the curative and effective rate was 91.7% (33/36), which was apparently superior to 77.1% (27/35) in the conventional therapy group (P < 0.05). The analgesic effect in the first 10 treatments in the comprehensive therapy group was apparently superior to that in the conventional therapy group (P < 0.05). ODI after treatment was improved significantly in both groups (both P < 0.05), in which the result in the comprehensive therapy group was superior to that in the conventional therapy group (P < 0.05). After treatment, the SF-36 values of gener al health, bodily pain, physiological functioning, social functioning and emotional functioning in the comprehensive therapy group were superior to that in the conventional therapy group (all P < 0.05). After 15 treatments, the level of serum TNF-alpha in the comprehensive therapy group was lowered as compared with that before treatment and lower apparently than that in the conventional therapy group (P < 0.05); after 30 treatments, it was also lower than that in conventional therapy group (P < 0.05).
  
  
  CONCLUSIONS
  In the guide of the theory of qi pathway, the comprehensive therapy of acupuncture and spinal adjustment intervention achieves the quick and good efficacy on LDH as compared with the conventional acupuncture and Tuina and improves the quality of life for the patients to certain extent. The analgesic effect of this therapy is relevant with the decrease of serum TNF-alpha.
authors.affiliation: Department of Acupuncture and Moxibustion, Affiliated HOsiptal of Tongren Occupation Technical College, Tongren 554300, Guizhou Province, China. yangjunxiong_320@163.com
authors.forename: Jun-Rion
authors.initials: JR
authors.lastname: Yang
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Zhang
authors.forename: Jian-Chun
authors.initials: JC
authors.lastname: Yu
authors.forename: Jing-Xian
authors.initials: JX
authors.lastname: Han
mesh_terms: D015669:Acupuncture Points; D015670:Acupuncture Therapy; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000097:blood / Q000628:therapy*; D008297:Male; D020393:Manipulation, Spinal; D008875:Middle Aged; D019413:Qi; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D014409:Tumor Necrosis Factor-alpha